0000849146-20-000064.txt : 20200403
0000849146-20-000064.hdr.sgml : 20200403
20200403105101
ACCESSION NUMBER: 0000849146-20-000064
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200401
FILED AS OF DATE: 20200403
DATE AS OF CHANGE: 20200403
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jensen Darren Jay
CENTRAL INDEX KEY: 0001642848
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35647
FILM NUMBER: 20772140
MAIL ADDRESS:
STREET 1: C/O LIFEVANTAGE CORPORATION
STREET 2: 9785 SOUTH MONROE ST. SUITE 300
CITY: SANDY
STATE: UT
ZIP: 84070
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Lifevantage Corp
CENTRAL INDEX KEY: 0000849146
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 841097796
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0630
BUSINESS ADDRESS:
STREET 1: 9785 S. MONROE STREET
STREET 2: SUITE 300
CITY: SANDY
STATE: UT
ZIP: 84070
BUSINESS PHONE: 801-432-9000
MAIL ADDRESS:
STREET 1: 9785 S. MONROE STREET
STREET 2: SUITE 300
CITY: SANDY
STATE: UT
ZIP: 84070
FORMER COMPANY:
FORMER CONFORMED NAME: LIFELINE THERAPEUTICS, INC.
DATE OF NAME CHANGE: 20041019
FORMER COMPANY:
FORMER CONFORMED NAME: YAAK RIVER RESOURCES INC
DATE OF NAME CHANGE: 19920703
FORMER COMPANY:
FORMER CONFORMED NAME: ANDRAPLEX CORP
DATE OF NAME CHANGE: 19920406
4
1
wf-form4_158592544343324.xml
FORM 4
X0306
4
2020-04-01
0
0000849146
Lifevantage Corp
LFVN
0001642848
Jensen Darren Jay
9785 SOUTH MONROE STREET, SUITE 400
SANDY
UT
84070
1
1
0
0
Chief Executive Officer
Common Stock
2020-04-01
4
M
0
4726
0
A
502758
D
Common Stock
2020-04-01
4
F
0
8673
10.25
D
494085
D
Performance Stock Units
2020-04-01
4
M
0
4726
0
D
Common Stock
4726.0
23630
D
On January 8, 2019, the reporting person was granted PSUs which vest only to the extent the specified financial performance criteria are achieved and subject to the reporting person's continued service with the issuer, as follows: (i) 1/2 of the earned award vested on the first anniversary of the grant date and (ii) an additional 1/12 of the earned award will vest as of the first day of each calendar quarter thereafter. The reporting person initially reported the number of shares that were eligible to be earned at target-level performance achievement. The performance criteria were achieved at a level above target; accordingly, the reporting person is eligible to earn 162% of the target number of units. The actual number of shares that vested on the reported transaction date was 162% of the at-target number of shares subject to vesting on that date and the number of PSUs beneficially owned following the reported transaction has been updated to reflect 162% of the target number of units.
Performance Stock Units ("PSUs") convert into common stock on a one-for-one basis.
These shares were withheld to satisfy tax withholding obligations in connection with the vesting of two stock unit awards and one PSU award granted on January 8, 2019.
/s/ Darren Jay Jensen
2020-04-03